Provided below is a list of Frequently Asked Questions. For answers to your specific billing questions, please contact our Customer Service Representatives at the facility in which you were seen; or, call the customer service number listed on your billing statement.
Who will bill my insurance? San Juan Regional Medical Center will first bill the health insurance company on your behalf. If the bill is unpaid because the insurance company states you no longer have health insurance coverage, we will send you a bill. If you have changed insurance companies, contact us as soon as possible so we can change the information on file and bill the account correctly.
Why am I being asked for my insurance information again? My doctor should already have it. Doctors keep their own patient information. Because your health insurance coverage may be different for a physician than it is for hospital services, we want to verify that we are billing the correct and current insurance.
I was in the hospital several weeks ago, why haven't I received a bill? For patients with health insurance: once your insurance company has been billed and has responded to us, we determine how much you may owe and will bill you.
I received a billing statement, but all it shows are total charges. Can I ask for an itemized bill? Yes. If you would like a copy of an itemized statement, please contact business services, 505.609.2800.
I have coverage under both my insurance and my spouse. Since the deductible is less under my spouses insurance, can you bill their insurance and not mine?
Unfortunately, under a provision called coordination of benefits, the hospital is required to bill the insurance that would be considered primary for you. Any health insurance for which you are the primary holder must be billed before any other health insurance.
Can I find out how much my emergency room service will cost and if my medical insurance will cover the visit before seeing the doctor? No. When someone comes to the Emergency Room, it is implied that they have a medical emergency. Specific regulations require that Emergency Room Clinicians first see the patient before we can discuss any financial questions. We understand that this restriction can be frustrating. However, the regulations are there to ensure everyone who comes to an Emergency Room will be seen regardless of their ability to pay.
How will I know how much I will need to pay? Your insurance policy should explain your benefits, the contract is between you and your insurance agency. If you do not have insurance we have options and we encourage you to visit our financial arrangements page. To determine if you qualify for payment assistance, contact a San Juan Regional Medical Center Financial Counselors near our main hospital registration between 8:00 a.m. to 4:30 p.m., Monday through Friday, or call 505.609.6288 or 1-800.878.6180.
Where can I find answers to questions about Medicare? Go to www.medicare.gov for more information on Medicare.
What is an Advance Beneficiary Notice (ABN)? An Advance Beneficiary Notice (ABN) is a written notice from either the physicians, providers or suppliers, before they provide a service or item to you, notifying you: That Medicare may deny payment for the specific service or item; The reason the physician, provider or supplier expects Medicare to deny the payment; That you may be personally and fully responsible for payment if Medicare denies payment. An ABN also gives you the opportunity to refuse to receive the service or item.
